1. Margin negative resection and pathologic downstaging with multiagent chemotherapy with or without radiotherapy in patients with localized pancreas cancer: A national cancer database analysis
- Author
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Joseph A. Miccio, Wesley J. Talcott, Timil Patel, Henry S. Park, Michael Cecchini, Ronald R. Salem, Sajid A. Khan, Stacey Stein, Jeremy S. Kortmansky, Jill Lacy, Amol Narang, Joseph Herman, Salma K. Jabbour, Christopher L. Hallemeier, Kimberly Johung, and Krishan R. Jethwa
- Subjects
Pancreatic cancer ,Chemotherapy ,Radiotherapy ,Surgery ,Neoadjuvant therapy ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Purpose: Margin-negative (R0) resection is the only potentially curative treatment for patients with pancreatic ductal adenocarcinoma (PDAC). Pre-operative multi-agent chemotherapy alone (MAC) or MAC followed by pre-operative radiotherapy (MAC + RT) may be used to improve resectability and potentially survival. However, the optimal pre-operative regimen is unknown. Methods: Patients with non-metastatic PDAC from 2006 to 2016 who received pre-operative MAC or MAC + RT before oncologic resection were identified in the National Cancer Database. Univariable and multivariable (MVA) associates with R0 resection were identified with logistic regression, and survival was analyzed secondarily with the Kaplan Meier method and Cox regression analysis. Results: 4,599 patients were identified (MAC: 3,109, MAC + RT: 1,490). Compared to those receiving MAC, patients receiving MAC + RT were more likely to have cT3-4 disease (76% vs 64%, p
- Published
- 2021
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